摘要
目的:观察评价益气疏肝方联合微创清创术治疗脓肿期肉芽肿性小叶性乳腺炎(GLM)及相关抑郁状态临床疗效。方法:采用前瞻性研究方法,选取80例就诊于山东中医药大学附属医院的GLM脓肿期患者,随机分为试验组(益气疏肝方+微创清创术组)和对照组(微创清创术组)各40例。观察治疗前,治疗2、4周期后患者中医情绪症状评分、乳房局部病灶范围、疼痛程度及血液中白细胞计数(WBC)、白细胞介素-6(IL-6)、C反应蛋白(CRP)指标。同时评价GLM临床治愈时间、临床治愈后乳房外观状态及愈后复发情况。结果:治疗2周期后,两组患者忧思多虑、神疲倦忘、烦躁无趣、情绪堕落、失眠多梦、寡言少语、心虚胆怯、腹胀纳呆、时有太息、胸胁胀痛症状相较于治疗前均有改善,试验组较对照组能明显改善上述中医情绪症状;治疗4周期后两组患者全部中医情绪症状较治疗前均明显改善,组间比较试验组优于对照组(P<0.05)。与治疗前相比,治疗后两组乳房局部病灶范围、疼痛程度及实验室指标均呈降低趋势,差异具有统计学意义(P<0.05);其中试验组明显低于同期对照组(P<0.05)。其中试验组明显低于同期对照组(P<0.05)。入组患者均于治疗4个月内达到GLM临床治愈状态,试验组患者临床治愈时间、治愈后乳房外观状态及复发率明显优于对照组(P<0.05),差异具有统计学意义。结论:益气疏肝方联合微创清创术可明显缩短GLM病程、减轻乳房外观损毁、降低复发率;同时减轻脓肿期GLM患者情绪抑郁、躯体焦虑症状,对防治患者相关抑郁状态具有显著效果。
Objective:To observe and evaluate the efficacy of Yiqi Shugan Formula(益气疏肝方)combined with minimally invasive debridement in the treatment of granulomatous lobular mastitis(GLM)in abscess formation stage and related depression.Methods:A total of 80 patients with GLM in abscess stage from The Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into experimental group(Yiqi Shugan Formula+minimally invasive debridement group)and control group(minimally invasive debridement group),40 patients in each group.Scores of TCM emotional symptoms,extent of local breast lesions,degree of pain and indexes of leukocyte count,interleukin-6(IL-6)and C-reactive protein(CRP)were observed before and after treatment.At the same time,the clinical cure time,breast appearance and recurrence of GLM were evaluated.Results:After 2 cycles of treatment,the symptoms of anxiety,fatigue and forgetfulness,irritability,sleeplessness,depravity,few words,weakness and timidity,abdominal distension,having a deep sigh sometimes,chest and rib distension and pain in both groups were improved compared with those before treatment,after 4 cycles of treatment,all the TCM emotional symptoms of the two groups were significantly improved,and the test group was superior to the control group(P<0.05).After treatment,the range of local breast lesions,the degree of pain and the laboratory indexes in the two groups all showed a decreasing trend,and the difference was statistically significant(P<0.05).The test group was significantly lower than the control group at the same time(P<0.05).All the patients in the treatment groups reached the clinical cure state of GLM within 4 months of treatment.The clinical cure time,breast appearance and recurrence rate in the experimental group were significantly better than those in the control group(P<0.05).Conclusions:Yiqi Shugan Formula combined with minimally invasive debridement can significantly shorten the course of GLM,reduce breast appearance damage,reduce recurrence rate,and reduce the symptoms of depression and physical anxiety in patients with GLM in abscess formation stage,inidacting a significant effect on the prevention and treatment of related depression.
作者
刘春妘
孟晓凡
房小芳
刘晓菲
LIU Chunyun;MENG Xiaofan;FANG Xiaofang;LIU Xiaofei(The First Clinical College,Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Department of Breast and Thyroid Surgery,The Affiliated Hospital of Shandong University of Tradi-tional Chinese Medicine,Jinan 250014,China)
出处
《山东中医杂志》
2024年第4期365-370,394,共7页
Shandong Journal of Traditional Chinese Medicine
基金
山东省自然科学基金面上项目(ZR2020MH356)
国家重点研发计划“中医药现代化研究”(2018YFC1704103)
山东省医药科技发展计划项目(编号:2018WS191)。
